title: Sensibility of the stump in adults with an acquired major upper extremity amputation.
abstract: OBJECTIVE
  To compare the sensibility of the stump in adults with an acquired major upper extremity amputation with the sensibility of the unaffected side and with the corresponding body parts of healthy controls, as well as to relate the sensibility of the stump to daily functioning.
  
  
  METHODS
  A survey with matched controls.
  
  
  METHODS
  A tertiary referral center.
  
  
  METHODS
  A referred sample of patients (n=30) with an acquired upper extremity amputation, at least 1 year after amputation, and control subjects (n=30) matched for age, sex, and hand dominance were evaluated.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  Three different modalities of sensibility were measured: (1) touch-pressure sensibility, tested using Semmes-Weinstein monofilaments; (2) stereognosis, detected using the Shape and Texture Identification test; and (3) kinesthesia. Daily functioning was assessed using the Upper Extremity Functional Status Module of the Orthotics and Prosthetics Users' Survey.
  
  
  RESULTS
  The mean time ± SD since amputation was 20±17.8 years. Twenty patients used a prosthesis. The stump sensibility was similar to that of unaffected hands and tended to be less than that of unaffected arms (P=.08). The patients using a prosthesis had significantly poorer touch-pressure sensibility in the stump compared with the nonusers (P=.04). However, touch-pressure sensibility and stereognosis were worse in the patients than in controls (P<.001 and P=.03, respectively). Two patients were able to identify shapes using their stump. Kinesthesia of the shoulders and elbows did not differ between the affected and unaffected side. Moreover, daily functioning was not related to sensibility.
  
  
  CONCLUSIONS
  The touch-pressure sensibility in the stumps of patients using prostheses was poorer than the sensibility in nonusers, and remarkably, the unaffected extremities of the amputees were less sensitive than the extremities of the controls.
authors.affiliation: University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, The Netherlands.
authors.forename: Willemijn
authors.initials: W
authors.lastname: van Gils
authors.forename: Heleen A
authors.initials: HA
authors.lastname: Reinders-Messelink
authors.forename: Frida
authors.initials: F
authors.lastname: Smit-Klaij
authors.forename: Raoul M
authors.initials: RM
authors.lastname: Bongers
authors.forename: Pieter U
authors.initials: PU
authors.lastname: Dijkstra
authors.forename: Corry K
authors.initials: CK
authors.lastname: van der Sluis
mesh_terms: D000328:Adult; D000368:Aged; D000671:Amputation, Surgical; D000672:Amputation Stumps; D005260:Female; D006801:Humans; D007699:Kinesthesis; D008297:Male; D008875:Middle Aged; D012677:Sensation; D013236:Stereognosis; D014110:Touch; D034941:Upper Extremity / Q000601:surgery*
keywords: Amputation stumps; OPUS; Orthotics and Prosthetics Users' Survey; Rehabilitation; STI; Sensation; Shape and Texture Identification; Stereognosis; Touch; Upper extremity